SCOTT W SOUTHARD MD INC
Medical Practice at Virginia Ranch Rd, Gardnerville, NV

License number
Nevada 6292
Category
Medical Practice
Type
Orthopaedic Surgery
License number
Nevada G60029
Category
Medical Practice
Type
Orthopaedic Surgery
Owner
Name: KATHY BARELA
Title: OFFICE MANAGER
Phone: (530) 541-4119
Address
Address 2
1520 Virginia Ranch Rd STE 1B, Gardnerville, NV 89410
2158 Jean Ave, South Lake Tahoe, CA 96150
National Provider ID: 1811136161
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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SCOTT W. SOUTHARD, M.D., INC

2158 Jean Ave, South Lake Tahoe, CA 96150

Industry:
Medical Doctor's Office
Registration:
Jul 5, 2001
State ID:
C2349760
Business type:
Articles of Incorporation
President:
Scott W. Southard (President)
Agent:
Scott W Southard,South Lake Tahoe, CA 96150 (Physical)

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